Donald R. Coustan - Medical Management of Pregnancy Complicated by Diabetes

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2013 by the American Diabetes Association, Inc. All Rights Reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including duplication, recording, or any information storage and retrieval system, without the prior written permission of the American Diabetes Association.

Printed in the United States of America
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The suggestions and information contained in this publication are generally consistent with the Clinical Practice Recommendations and other policies of the American Diabetes Association, but they do not represent the policy or position of the Association or any of its boards or committees. Reasonable steps have been taken to ensure the accuracy of the information presented. However, the American Diabetes Association cannot ensure the safety or efficacy of any product or service described in this publication. Individuals are advised to consult a physician or other appropriate health-care professional before undertaking any diet or exercise program or taking any medication referred to in this publication. Professionals must use and apply their own professional judgment, experience, and training and should not rely solely on the information contained in this publication before prescribing any diet, exercise, or medication. The American Diabetes Associationits officers, directors, employees, volunteers, and membersassumes no responsibility or liability for personal or other injury, loss, or damage that may result from the suggestions or information in this publication.

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Alexandria, Virginia 22311

DOI: 10.2337/9781580405102

Library of Congress Cataloging-in-Publication Data
Medical management of pregnancy complicated by diabetes / Donald R. Coustan, editor. -- 5th ed.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-1-58040-510-2 (alk. paper)
I. Coustan, Donald R. II. American Diabetes Association.
[DNLM: 1. Pregnancy in Diabetics--therapy. 2. Diabetes Mellitus. 3. Diabetes, Gestational--therapy. 4. Pregnancy Outcome. WQ 248]
618.3--dc23
2012049594
eISBN: 978-1-58040-536-2

This book is dedicated to the many mothers with diabetes
who have allowed us to participate in their care over the years,
being involved in the most important events in their families lives.
We continue to learn from each of you,
and applying those lessons has advanced our ability
to care for women with diabetes during their pregnancies.

Contents

T his fifth edition is intended to provide up-to-date guidance on all aspects of the care of pregnant women with preexisting diabetes, whether she has type 1 or type 2 diabetes, and with gestational diabetes. The care of pregnant women with diabetes and gestational diabetes requires a committed health-care team and considerable resources. It is our hope that the information in this book will be helpful in enabling the various health-care professionals who make up that team to have access to practical advice and carry out their mission. Each of the contributors is engaged actively in providing care to pregnant women with preexisting diabetes and gestational diabetes. Although there are many reasonable approaches to providing that care, we have outlined herein those that we find to be effective.

T he editor is indebted to Dr. Lois Jovanovic, who lovingly edited the first four editions of this book. She has set a high standard for this fifth edition. Her contributions to our understanding of diabetes in pregnancy and its treatment have been seminal.

In addition to the contributors to this current fifth edition, the editor would like to acknowledge the important contributions of the many health professionals who have contributed to previous editions of this book; the current edition is built on a very strong foundation:

Richard M. Cowett, MD
Stephanie Dunbar, MPH, RD
Donna Jornsay, RN, BSN, CPNP, MSS, ACSW
Sue Kirkman, MD
John L. Kitzmiller, MD
Lisa Marasco, MA, IBCLC, FILCA
Noreen Hall Papatheodorou, MSS, ACSW
Anne M. Patterson, RD, MPH

EDITOR-IN-CHIEF
Donald R. Coustan, MD
Maternal-Fetal Medicine Specialist
Women & Infants Hospital of Rhode Island
Providence, RI
Professor of Obstetrics and Gynecology
Warren Alpert Medical School of Brown University
Providence, RI

Susan Biastre, RD, LDN, CDE
Clinical Nutrition Specialist
Women & Infants Hospital of
Rhode Island
Providence, RI

Julie M. Daley, RN, MS, CDE
Teaching Associate in Obstetrics and Gynecology
Warren Alpert Medical School of Brown University
Senior Diabetes Nurse Clinician
Division of Maternal-Fetal Medicine
Women & Infants Hospital of
Rhode Island
Providence, RI

Carol J. Homko, RN, PhD, CDE
Associate Research Professor,
Departments of Medicine (Section of Endocrinology) and Obstetrics & Gynecology
Temple University School of Medicine
Philadelphia, PA

Siri Kjos, MD, MSEd
Professor
Department of Obstetrics and Gynecology
Harbor UCLA Medical Center
Torrance, CA

Abbot R. Laptook, MD
Medical Director, Neonatal Intensive Care Unit
Women & Infants Hospital of Rhode Island
Providence, RI
Professor of Pediatrics
Warren Alpert Medical School of Brown University
Providence, RI